This dissertation, containing two journal-formatted manuscripts, examines factors associated with international students' psychosocial adjustment to life in the United States. In the first manuscript, I systematically reviewed 64 studies reporting predictors of international student adjustment, which were published in English language peer-reviewed journals from 1990 to 2008. I summarized predictors by adjustment outcomes and assessed the methodological quality of individual studies. In the second manuscript, I investigated mechanisms through which acculturation influenced psychosocial adjustment of Chinese international students, by electronically surveying a sample of 508 Chinese international students from four universities in Texas. Specifically, the mechanisms investigated in this report refer to the mediating and moderating effects of social interaction and social connectedness with host nationals upon the acculturation-adjustment linkages. Results portrayed in the first manuscript showed stress, social support, English language proficiency, region/country of origin, length of residence in the United States, acculturation, social interaction with Americans, self-efficacy, gender, and personality were among the most frequently reported predictors of international students' psychosocial adjustment. The mean methodological score of the reviewed studies was 6.25 (SD=1.8; maximum possible score=11). The reviewed studies overcame selected methodological limitations pointed out by Church in his review, but show room for continued improvement. Results portrayed in the second manuscript showed social connectedness with Americans mediated the links between adherence to the host culture (acculturation dimension) and psychosocial adjustment. Social interaction with Americans moderated the association between adherence to the home culture (acculturation dimension) and depression. Findings from this dissertation have implications for health promotion research and practice. First, this dissertation calls for a revision in the sojourner adjustment framework to address the shared elements underlying both adjustment domains (psychological and sociocultural). Second, more studies are needed to a) examine macro-level factors and currently under-investigated micro-level factors, b) test theories that integrate micro- and macro-level factors, c) examine mediation and moderation effects, and d) systematically employ longitudinal designs and comparison groups. Third, health promotion professionals would do well to address predictors and mechanisms found in this dissertation when developing evidence-based interventions for international students.

This paper explores Mazo de la Roche’s peculiar articulation of the Bildungsroman in the first of Jalna’s sequels, Whiteoaks. It argues that the text’s psychosocially aberrant protagonist, Finch Whiteoak, is a Bildungsheld whose modern coming-of-age process of accommodation and assimilation into a socio-specific norm is not as much a progression toward the centre as it is a simultaneous progression/regression toward a reification of his exemplary marginal status as an other amidst others. This paper further contends that this unique process is made possible only by Finch’s particularly unstable and eccentric otherness—established through his treatment by his family as variously mentally ill rather than disabled—and that this process is both externally regressive in a vein similar to the modern, female Bildungsroman and internally progressive in the vein of the classic, male Künstlerroman. In order to accommodate this duality of publicly typical and privately subversive otherness, Finch must navigate the diegetic realm’s social boundaries and liminal spaces through a series of “double lives,” in which the other is ultimately found within the home context and potentially subversive centralities outside of Jalna are sacrificed for the sake of representative marginalities at home.

Vårdpersonal har i studier beskrivits utsättas för stress, emotionell utmattning samt utbrändhet genom lågt inflytande eller låg kontroll över ställda krav. Studier inom offentlig verksamhet visar också att det finns arbetstagare som befunnit sig i arbetsplatsinlåsning, yrkesinlåsning eller i dubbelinlåsning. Denna enkätstudie ämnade att med mätinstrumentet Psykosocial arbetsmiljökartläggning (PAK) mäta två klinikers psykosociala arbetsmiljö hos 109 undersköterskor och skötare på ett sjukhus i Mellansverige. Studien ämnade även att mäta om arbetsplatsinlåsning, yrkesinlåsning samt dubbelinlåsning förekom och om det fanns ett samband mellan den psykosociala arbetsmiljön och inlåsningsbegreppen. Resultatet av den psykosociala arbetsmiljöns mätning visade att egenkontroll, arbetsledning och arbetsbelastning skattades lågt medan stimulans och arbetsgemenskap skattades positivt. Antal inlåsta individer översteg 20 % på alla inlåsningsbegrepp. Studien fann även ett statistiskt signifikant samband mellan begreppet psykosocial arbetsmiljö och arbetsplats/-yrkesinlåsning samt dubbelinlåsning. Studien bör gå vidare med kvalitativ metodik, att hos arbetstagarna ta reda på de bakomliggande orsakerna till studiens resultat.

This grounded theory study examined the psychosocial processes that contributed to juvenile detention as perceived by the adolescent. Twelve youth (seven males, five females) between 13 and 16 years of age were interviewed at a local detention center. A basic social psychological process, Hoping for a better life, was identified from the interviews. Three stages of this process were explicated as youth recounted a significant loss early in life, reacting externally with delinquent actions, and discovering choices for new behaviors. In Stage One, Enduring the loss was characterized by loss; youth described losing a significant adult, usually a biological parent. Detaching was the basic social structural process (BSSP) used by youth to live with, or to endure, the loss. The themes of detaching were losing a significant adult, resenting the loss, unrelenting grief, unremitting loneliness, and experiencing vulnerability. In Stage Two, Persisting the dissension conceptualized the structural process of repudiating. The BSSP of repudiating provided a transition from the first stage and consisted of three themes. The themes, contingent on how dissension was externalized, included demonstrating internal discord, choosing to remain, and breaking the rules. In this stage, youth repudiated or rejected the rules and norms of socializing agents. Stage Three, Discovering a path, was articulated by youth after being detained in the detention center where opportunity existed for learning self control and self regulation. The BSSP of connecting emerged from the data. Connecting included the four themes of balancing, differentiating, futuring and experiencing equilibrium. Meaningful study findings included discovery of the impact of early significant loss of a parent and sustained substance use.

It is commonly believed that breast cancer dragon boating benefits survivors in a range of psychosocial areas, but there have been few empirical studies to investigate such relationships. An interpretive description design and a critical health promotion approach were used to explore the psychosocial experiences of women who breast cancer dragon boat. In-depth interviews with six participants were analyzed. Themes that arose from the data are: (1) moving past isolation — networks of like-minded support, (2) taking control,(3) journey into adventure, (4) affirmative outlook, (5) confronting painful experience, (6) rebuilding identity, (7) and spiritual engagement. The findings illustrate that dragon boating provides breast cancer survivors with a significant venue for change and the opportunity to move beyond traumatic elements of cancer.

Sergančiųjų įvairiomis psichikos ligomis nemažėja tiek pasaulyje, tiek Lietuvoje, o aplinkos veiksniai, tokie kaip ekonominis nestabilumas, bedarbystė ir kita, skatina šių sutrikimų didėjimą. Be psichinio funkcionavimo problemų psichikos ligos beveik visada sukelia socialinio funkcionavimo sutrikimus. Sergančiųjų savarankiškumo atstatymui ir jų visavertei integracijai į visuomenę svarbi psichosocialinė reabilitacija, kurios pagrindiniai etapai – intensyvi klinikinė reabilitacija, kol pacientas gydomas ligoninėje, ir socialinių paslaugų teikimas bendruomenės institucijose. Šio darbo tikslas – išanalizuoti ir palyginti žmonių su psichikos sutrikimais reabilitacijos būdus ir galimybes bendruomenėje ir stacionarioje gydymo įstaigoje (Respublikinėje Vilniaus psichiatrijos ligoninėje). Pirmoje darbo dalyje pateikta psichosocialinės reabilitacijos samprata ir svarba, supažindinta su psichiatrijos ligoninėje ir bendruomenėje teikiamomis psichosocialinės reabilitacijos paslaugomis. Tiriamojoje dalyje pateikiami atlikto tyrimo rezultatai. Paaiškėjo, kad asmenys, turintys psichikos sutrikimų, gydydamiesi ligoninėje gauna pakankamai informacijos ir įsitraukia į įvairias reabilitacines užimtumo veiklas pagal saviraiškos poreikius. Tuo tarpu, užimtumo veikloje bendruomenės institucijose dalyvauja ženkliai mažiau tiriamųjų nei ligoninėje. / The number of people with mental trouble has not been decreasing in the whole world as well as in Lithuania. Moreover, the environmental factors such as economical instability, unemployment and other determine the increase of this kind of disorder. Apart from disorder of mental behavior mental diseases almost always evoke disorder of social behavior. Psychosocial aftercare is very important for reestablishment of independency and proper integration of the sick into the society. The main stages of the psychosocial aftercare are intense clinical aftercare while the patient is treated in hospital and social services in community institutions. The goal of the thesis is to analyze and compare different aftercare methods and opportunities in the community and stationary medical institutions (Republican Vilnius psychiatric hospital) for mentally disabled people. The conception and importance of psychosocial aftercare are presented in the first part of the thesis. Moreover, psychosocial aftercare services supplied in psychiatric hospitals and communities are revealed. The second part discloses the results of the research. It has been established that people with mental disability get enough information in hospitals and get involved into different activities of aftercare according to needs of self-expression. On the other hand, less people participate in aftercare activities in community institutions if compared with hospitals.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Background: Low back pain (LBP) is the most prevalent musculoskeletal condition experienced by human beings and the most common cause of disability in developed nations. Psychosocial factors, involving aspects of social and psychological behaviour, have previously been documented as potential risk factors in the development of adult LBP. However, more research is required to fully understand the role of psychosocial risk factors on the prevalence of LBP amongst adolescents. Objective: To determine the prevalence of LBP and to identify selected psychosocial risk factors associated with LBP amongst Grade 12 learners in the Greater Durban area. Methods: A population-based study was conducted amongst a stratified random sample of 20 public secondary schools in all three educational districts in the Greater Durban area. Data was collected by means of a structured questionnaire administered to the sample population consisting of Grade 12 learners. Using an exploratory research design, the individuals reported on demographics as well as prevalence, severity, frequency and chronicity of LBP. In addition, data was obtained regarding various psychosocial risk factors including depression, exam stress and anxiety, socio-economic status, family history of LBP, smoking, alcohol and drug abuse amongst the respondents. Results: The prevalence of LBP was 57.42% with a median frequency of 8 times a month. About a third (33.9%) of the respondents experienced difficulty bending whilst 35% reported that their LBP spread down to the legs below their knees. The daily activity most affected by LBP was having a good night‟s sleep (50.6%), followed closely by playing sports (47.4%) and concentrating in class (46.6%). The majority of the respondents that suffered from LBP had taken pain relief medication (47.1%) whilst only 21% of the respondents had missed school because of LBP. With regards to the psychosocial risk factors under investigation, three of the risk factors did not show any association to LBP. They included socio-economic status, smoking and recreational drug use. In contrast, five psychosocial risk factors showed an 6 association to LBP. They included alcohol abuse, family history, exam stress, anxiety and depression. Finally, after adjusting for all other risk factors for adolescent LBP, depression and high exam stress showed the strongest correlation with the occurrence of LBP amongst Grade 12 learners in the Greater Durban area. Conclusion: LBP amongst adolescents is a common problem that increases with age, representing a risk for LBP in adulthood. The researcher is of the opinion, that this illustrates the need for further investigations with more profound studies on the risk factors so that more light can be shed on how to manage this ever-growing problem.

Mothers with cancer are required to make medical and social decisions while attempting to balance their own physical, psychological and social needs with the needs of their children. To explore the decision-making process, in-depth interviews were conducted with 7 mothers with a cancer diagnosis and children aged birth to 6 years. They were asked to describe: 1) types of decisions; 2) process they used to make decisions; 3) conditions of their lives; 4) meanings assigned to their decisions. The grounded theory method was used. The driving force behind decision-making was the mothers’ desire to maintain the mother-child bond, influenced by the context of their lives. Making decisions to maintain the mother-child bond involved managing: 1) distance; 2) physical changes; 3) the information shared; and 4) the ongoing chain of decisions. The findings have implications for improving the quality and usefulness of psychosocial supports for mothers with cancer and their families.

Mothers with cancer are required to make medical and social decisions while attempting to balance their own physical, psychological and social needs with the needs of their children. To explore the decision-making process, in-depth interviews were conducted with 7 mothers with a cancer diagnosis and children aged birth to 6 years. They were asked to describe: 1) types of decisions; 2) process they used to make decisions; 3) conditions of their lives; 4) meanings assigned to their decisions. The grounded theory method was used. The driving force behind decision-making was the mothers’ desire to maintain the mother-child bond, influenced by the context of their lives. Making decisions to maintain the mother-child bond involved managing: 1) distance; 2) physical changes; 3) the information shared; and 4) the ongoing chain of decisions. The findings have implications for improving the quality and usefulness of psychosocial supports for mothers with cancer and their families.

Masters Research - Master of Philosophy (MPhil) / The psychosocial stress of social conflict contributes to the development of depression and anxiety in those individuals vulnerable to its effects, yet the factors that contribute to vulnerability remain unclear. Researchers investigating factors such as behaviour and physiology have used the animal resident/intruder social conflict model whereby a young male rodent (intruder) is placed into the home cage of an older male (resident) that is trained to attack and defeat all intruders. Findings reported previously have shown that defeated intruders displayed medium to longer-term stress-related changes in behaviour and physiology, with considerable variability in the severity of these changes reported from one individual to another. Interestingly, a reduction in severity of behavioural and physiological changes was associated most significantly with intruders that deployed ‘active coping’ behaviours during the social defeat interaction than animals that deployed ‘passive coping’. However, these findings do not describe the short-term effects, raising the question; does coping style also influence the short-term stress response? We investigated the relationship between coping behaviour adopted by intruders during a 10 minute social conflict culminating in defeat and both acute peak plasma corticosterone (CORT) stress hormone levels and number of cells expressing Fos protein in eight brain regions. Our investigations revealed that higher levels of fight and guard behaviours were associated with lower peak plasma CORT levels compared to ready submission, and that higher levels of fight were associated with fewer numbers of Fos-ir cells in prefrontal cortex (PFC), amygdala (Am), and paraventricular nucleus (PVN) brain regions. In general terms, these findings indicate that coping behaviour deployed during social conflict influences the endocrine and neurobiological elements of the acute phase of the HPA axis response to psychosocial stress. Intruders that deploy an ‘active’ coping style including fight behaviours display significantly smaller physiological and neurobiological alterations in the acute response than intruders that deploy a ‘passive’ coping style during social conflict. These results demonstrate that the vulnerability to the effects of psychosocial stress are ameliorated by actively engaging with the perpetrator rather than passively taking the attack, and that adopting the behaviour fight is most protective. Further elucidation of the neural mechanisms that underpin the reduction in stress-induced effects is warranted.